ICU vs Cardiac Step-down: Young RN Needs Job Advice

[jpizzle11]

I've got about 2 years of experience as a telemetry nurse. My ultimate goal is to become an NP who specializes in critical care. I'm applying for 2 jobs right now and, although it's too early to tell, I may end up being offered both. I'm looking for any helpful advice on which would be better.

One job is at a very large, prestigious teaching hospital on a cardiac step-down unit.

The other job is in a small ICU at a small, not-so-prestigious hospital.

Pay and location are comparable.

Which one would be better to take for a career in ICU? I know it may seem obvious to pick the ICU job, but I'm afraid that it's too small to have really relevant experience (very few vents, art lines, etc.) and that I might actually learn more on the cardiac step-down unit. Also, I just didn't have the same "good feeling" when I saw the ICU in person as when I saw the cardiac unit. But I also really want to transition into critical care within the next 2-5 yrs.

Any suggestions for a young nurse who doesn't have a lot of experience making big decisions?

[kidnurse98]

Pick the large/teachng card step down job...trust me. I did that type of work for many many years. I also worked in the ICU's as an agency nurse in small community hospitals around town....the patients we had on our unit at the large hospital were just about the same acuity as the patients in the small ICU's. Only differences were the vents and some med drips. You will learn and see a variety of different things on a unit like that (card step down/lg hospital) vs. noting really exciting after a while in the small ICU....anything really cool/exciting will probably be sent out to the big hospital! Lol.

Once you get your foot in the door you'll be able to transfer to the unit in the large hospital....

Good Luck!

[JoyfulRN14, BSN, RN]

If I was in your shoes, I would pick the cardiac step-down in the big teaching hospital. If you show your worth in that unit, it won't be too hard to transfer to their ICU. Internal transfers are easier than starting all over again at a new hospital.

Also, if you're working there I'm sure they have a lot of conferences/seminars/education etc. that you can attend to increase your knowledge.

For example, at my hospital once a month one of the critical care physicians does a one hour lecture on a relevant topic (this morning was chest traumas seen in the ED - pneumos, flail chest, tamponade, etc.). They are open to any hospital employees. There's education going on ALL THE TIME there, skills labs practicing codes, you name it.

Get your foot in the door at the hospital you want, and work your butt off there to shine and you'll make it to ICU

[orangepink, NP]

I agree with the previous posts.